Wine Club

Membership Change Form

* First Name:

* Last Name:

* Email Address:

Company:

* Day:

Mobile:

Evening:

Address:
Address Second Line:

City:

State:

Zipcode:

Check Here if Same as Billing.

Address:
Address Second Line:

City:

State:

Zipcode:

To change your membership type, please select one of these options:

To change delivery status, please select one of these options:

Check Here if you would like to change your credit card on file, and your Wine Club Concierge will contact you for the new card number.

Or, you can easily update your credit card information by logging into your Online Store account.

Check Here to Cancel Membership.

* Please tell us why you would like to cancel:

Check Here if you would like your Wine Club Concierge to call you for any reason.

Best number to reach you:

Best time to call:

Please enter any other comments here:

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